氯诺昔康超前镇痛对开胸患者术后芬太尼镇痛影响的观察及护理  

Effect of Preemptive Analgesia with Lornoxicam to Patient - Controlled Intravenous Analgesia with Fentanyl in Patients Undergoing Chest Surgery

作　　者：郑玩华[1] 丁三强[1] 杨丹娜[1] 陈仲群[1] 程明华[1] 

机构地区：[1]汕头大学医学院第一附属医院,广东汕头515041

出　　处：《国际护理学杂志》2007年第7期734-737,共4页international journal of nursing

基　　金：广东省汕头科技局重点科技计划项目（2004102）

摘　　要：目的观察氯诺昔康超前镇痛对开胸术后病人自控静脉镇痛（PCIA）芬太尼用量的影响。方法32例ASAⅠ～Ⅱ级择期行开胸手术病人,随机分成观察组和对照组,每组各16例。观察组于手术切皮前及关闭胸腔时分别静脉注射氯诺昔康8mg。两组术毕均用芬太尼PCIA,镇痛配方为芬太尼10μg/kg,氟哌利多5mg,以生理盐水稀释至100ml。负荷剂量芬太尼1μg/kg,背景输注2ml/h,PCA每次1ml,锁定时间10min。镇痛期间定时行视觉模拟镇痛评分（VAS）。结果两组病人镇痛效果接近,VAS无统计学差异（P〉0.05）;观察组24h内芬太尼用药量明显少于对照组（P〈0.05）。结论氯诺昔康超前镇痛能明显减少PCIA芬太尼的用药量及不良反应。Objective To investigate the influence of lomoxicam to patient - controlled intravenous analgesia （PCIA） with fentanyl in patients undergoing chest surgery. Methods 32 patients （ASAⅠ～Ⅱ ） elective for chest surgery under general anesthesia were randomized to either test group or controlled group with 16 cases each . PCIA with fentanyl was given in all patients . The analgesic prescription included fentanyl 10 μg/kg anddroperidol 5 mg diluted with NS to 100 ml. Aloading dose of fentanyl 1 ug/kg with ondansetron 8mg was injected, and the continuous infused rate was 2ml/h, and the bolus dose was lml and lock - out interval 10 minutes. The test group was given additional treatment of 8mg lomoxicam iv at the time before operation and at the end of operation. Results The test group had the same analgesic efficacy as the controlled group. There was no statistical difference in visual analgesia score （P 〉 0. 05） . The total dosage of fentanyl of the test group （49. 3 ± 3. 2） ml was significantly less than that of the controlled group （67. 7 ± 3. 0） ml （P〈0. 01 ） . Conclusion Preemptive analgesia with lomoxicam might significantly decrease the dosage and the side effects of PCIA with fentanyl.

关 键 词：氯诺昔康 芬太尼 镇痛 胸科手术 

分 类 号：R473[医药卫生—护理学]